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ATLANTA (March 22, 2022) — The National Association of Chronic Disease Directors’ (NACDD) Chief Executive Officer (CEO) John W. Robitscher, MPH, and Senior Director of Health Equity, Robyn Taylor, MBA, have issued the following statement for the National LGBTQ Health Awareness Week (March 21-25):
“Lesbian, Gay, Bisexual, Transgender, Queer and Questioning, Intersex, Asexual, and other gender and sexual minorities (LGBTQIA+) experience severe inequities in healthcare access and health outcomes.
NACDD is deeply concerned that legislation in several states marginalizes the LGBTQIA+ community and transgender people specifically by prohibiting participation in wellness activities and access to necessary healthcare services. NACDD calls upon lawmakers to end discrimination against LGBTQIA+ people and to reject measures that would further create social stigma and prejudice against this community.
Additionally, NACDD encourages funders to support initiatives that will help to identify better data to explore the complexity of LGBTQIA+ health needs, so these needs can be addressed more comprehensively.
While LGBTQIA+ individuals have many of the same health concerns as the general population, they experience unique health challenges, discrimination, and disparities.
Research suggests that the LGBTQIA+ community is more likely to experience disabilities. Because of social stigma and discrimination, LGBTQIA+ individuals have higher rates of depression and anxiety as well as substance use disorders. LGBTQIA+ youth also experience greater risk for mental health conditions and suicidality.
According to CDC’s 2017 National Youth Behavior Risk Survey, LGBTQIA+ youth are twice as likely to report experiencing persistent feelings of sadness or hopelessness while transgender youth face further disparities; transgender youth are twice as likely to experience depressive symptoms, seriously consider suicide, and attempt suicide.
Furthermore, LGBTQIA+ people are more likely to be impacted by sexual and physical violence. In 2021, at least 57 transgender or gender nonbinary people in the U.S. were fatally shot or killed by other violent means. About 96% of the individuals killed were Black or Latinx transgender women. Unfortunately, the total number of fatalities likely is much higher, considering the deaths of trans and gender non-binary people often are underreported, and the victims often are misgendered.
In addition to the higher rates of illness and health conditions, some LGBTQIA+ individuals are more likely to experience barriers in obtaining care. In a 2018 survey by the Center for American Progress, one in four LGBTQIA+ people reported experiencing healthcare discrimination. More specifically, 8% of lesbian, gay, and bisexual adults and 29% of transgender adults reported that a healthcare provider refused to see them because of their sexual orientation or gender identity.
In a 2015 survey by the National Center for Transgender Equality, 33% of respondents had experienced a negative interaction with a healthcare provider because of their gender identity in the year prior. Other barriers to healthcare access include: substandard care, including mistreatment from healthcare providers, and inadequate or lack of informed treatment.
In fact, there are many social determinants of health that intersect with and reinforce societal stressors and stigmas within the healthcare system. LGBTQIA+ people also encounter discrimination in employment, relationship recognition, identity recognition, and insurance coverage regularly; consequently, they are less likely to be able to afford vital healthcare.
For LGBTQIA+ individuals who also identify as Black, Native/ Indigenous, Asian, Pacific Islander, Hawaiian, Middle Eastern, Latinx, or as People of Color (POC), barriers to care and health disparities are even more significant. For instance, LGBTQIA+ POC have disproportionately higher rates of homelessness.
A 2014 survey of human service providers serving homeless youth, for instance, reported that 31% of the LGBTQIA+ youth they served identified as Black, despite Black youth making up only 14% of the general youth population in 2014. According to a 2022 Trevor Project report, nearly half (44%) of Native/Indigenous LGBTQIA+ youth have experienced homelessness or housing instability at some point in their life.
NACDD remains committed to improving health equity among all oppressed and marginalized communities, including Lesbian, Gay, Transgender, Bisexual, Queer and Questioning, Intersex, Asexual, and other gender and sexual minorities.
Working with informed partners, we have identified our own internal areas where, as an Association, we can improve our services to support the LGBTQIA+ community in reducing barriers to health. We urge our colleagues to join us in strengthening their commitment in this area.”
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The National Association of Chronic Disease Directors
Promoting Health. Preventing Disease.
The National Association of Chronic Disease Directors (NACDD) and its more than 7,000 Members seek to strengthen state-based leadership and expertise for chronic disease prevention and control in states and nationally. Established in 1988, in partnership with the U.S. Centers for Disease Control and Prevention, the NACDD is the only membership association of its kind to serve and represent every chronic disease division in all states and U.S. territories. For more information, visit chronicdisease.org.